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Chediak-Higashi syndrome (CHS) is a rare autosomal recessive genetic disorder characterized by severe immunodeficiency, albinism and coagulation deficiency. Mostly diagnosed in early childhood, this devastating condition is associated with lysosomal abnormalities attributed to the absence or impaired function of lysosomal trafficking regulator caused by mutations in the CHS1/LYST gene. In current study, we report a case of late-onset CHS caused by two novel compound heterozygous CHS1/LYST mutations: c.8407C > T, leading to early termination of translation at residue Gln2803 (p. Gln2803Ter), and a small deletion c. 4020_4031del, resulting in an in-frame deletion of three amino acid residues (p. Asp1343_Val1346del). Both variants retain a large part of the CHS/LYST protein, particularly p. Asp1343_Val1346del, which preserves critical functional BEACH and WD40 domains in the C terminal, potentially maintaining residual activity and alleviating patient symptoms. The timeline of SARS-CoV-2 infection and rapid symptom progression suggests that the viral infection may have trigger the accelerated phase development leading to a poor prognosis.
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The aim of this study was to evaluate the surgical technique of microresection of vestibular schwannoma by removing the posterior wall of the internal auditory canal (IAC) under neuroelectrophysiological monitoring and 30° neuroendoscopy, with respect to the protection of facial and auditory nerve function. Forty-five cases of microscopic resection of auditory neuromas were performed through a posterior approach to the inferior occipital sigmoid sinus using a 30° neuroendoscope to assist in the removal of the posterior wall of the IAC during surgery. Patients underwent cranial enhancement magnetic resonance imaging examination and functional assessment of the facial and auditory nerves before and after surgery, and clinical data were collected for retrospective analysis. All tumors were removed in 41 patients, and most of the tumors were removed in 4 patients. The facial nerve was anatomically preserved in 43 patients (95.6%), and the percentage of facial nerve function preservation (House-Brackmann grade I-II) was 84.4%. Forty patients (88.9%) had anatomical preservation of the auditory nerve, with a 66.7% functional preservation rate. At 3 to 39 months of follow-up, 45 patients were reviewed with 3.0 T-enhanced magnetic resonance imaging, and no tumor recurrence was observed in any of the patients. Microscopic resection of auditory neuroma through the posterior approach of the inferior occipital sigmoid sinus with intraoperative use of 30° neuroendoscopic assistance to abrade the posterior wall of the IAC can eliminate dead space in certain anatomical areas during surgery and minimize surgical damage to the facial and auditory nerves, which is the basis for preservation of facial and auditory nerve function.
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Two-dimensional metal dichalcogenides have demonstrated outstanding potential as cathodes for magnesium-ion batteries. However, the limited capacity, poor cycling stability, and severe electrode pulverization, resulting from lack of void space for expansion, impede their further development. In this work, we report for the first time, nickel sulfide (NiS2) hollow nanospheres assembled with nanoparticles for use as cathode materials in magnesium-ion batteries. Notably, the nanospheres were prepared by a one-step solvothermal process in the absence of an additive. The results show that regulating the synergistic effect between the rich anions and hollow structure positively affects its electrochemical performance. Crystallographic and microstructural characterizations reveal the reversible anionic redox of S2-/(S2)2-, consistent with density functional theory results. Consequently, the optimized cathode (8-NiS2 hollow nanospheres) could deliver a large capacity of 301 mA h g-1 after 100 cycles at 50 mA g-1, supporting the promising practical application of NiS2 hollow nanospheres in magnesium-ion batteries.
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Owing to its high volumetric capacity and natural abundance, magnesium (Mg) metal has attracted tremendous attention as an ideal anode material for rechargeable Mg batteries. Despite Mg deposition playing an integral role in determining the cycling lifespan, its exact behavior is not clearly understood yet. Herein, for the first time, we introduce a facile approach to build magnesiophilic In/MgIn sites in situ on a Mg metal surface using InCl3 electrolyte additive for rechargeable Mg batteries. These magnesiophilic sites can regulate Mg deposition behaviors by homogenizing the distributions of Mg-ion flux and electric field at the electrode-electrolyte interphase, allowing flat and compact Mg deposition to inhibit short-circuiting. The as-designed Mg metal batteries achieve a stable cycling lifespan of 340 h at 1.0 mA cm-2 and 1.0 mAh cm-2 using Celgard separators, while the full cell coupled with Mo6S8 cathode maintains a high capacity retention of 95.5% over 800 cycles at 1 C.
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OBJECTIVE: To investigate the clinical effect of the supraorbital keyhole approach (SKA) via a forehead wrinkle incision in the resection of tumors in the anterior skull base and sellar region. METHODS: Sixty patients with tumors located in the anterior skull base and sellar region treated through the SKA in our hospital from 2017 to 2020. The skin incision and bone flap position were designed individually according to the size and growth of the tumor. The clinical data of the patients were retrospectively analyzed. RESULTS: Based on the feasibility of this surgical approach, personalized skin incisions and bone flaps were designed for different lesions. Among the 60 patients, gross total resection was achieved in 53 cases (88.3%), for meningiomas 97.8% (46/47) and near-total resection in 7 cases (11.7%). In the survey of the patients' scale scores toward skin incision after operation, the "no pain" level was 90.0% (54/60) and 91.7% (55/60) for the level of "very satisfactory" of the aesthetic of the skin incision (as shown in Supplementary Digital Content, Table 2, http://links.lww.com/ SCS/D742). Three patients whose satisfaction with the aesthetic of the incision excelled scale 3, suggesting that they were not completely satisfied with the wound healing. No permanent skin incision discomfort was noted during follow-up. There were no surgical deaths. CONCLUSIONS: The SKA via forehead wrinkle incision is a flexible and feasible method for tumors near the midline of the anterior skull base and sellar region. However, this approach requires strict preoperative planning, which includes choosing appropriate tumors and applicable forehead wrinkles.
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Neoplasias Meníngeas , Meningioma , Estética Dentária , Testa/cirurgia , Humanos , Neoplasias Meníngeas/cirurgia , Meningioma/cirurgia , Estudos Retrospectivos , Base do CrânioRESUMO
Treg is essential to limit the extend and duration of the immune response, but its stability is still under debate. Here we demonstrate that IL-17-producing Treg cells (Th17-like cells) increased in peripheral blood of patients with Systemic Lupus Erythematosus (SLE). Notably, the Th17-like cells from patient with active SLE were characterized with some phenotype and function of Th17 cells. Upon stimulation, Helios-Foxp3â¯+â¯CD4+ T cells decrease Foxp3 expression but increase expression of IL-17 and RORγt. Damage associated molecule pattern and inflammatory cytokines are important for induction of IL-17 expression in Treg cells. The Th17-like cells from patients with active SLE lose suppressive function and have robust response to stimulation of autoantigens. We also observed that the level of Th17-like cells in peripheral blood is closely associated with the clinical index of SLE. These findings suggest that instability of Treg plays a critical role in pathogenesis of autoimmune diseases.
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Fatores de Transcrição Forkhead/imunologia , Lúpus Eritematoso Sistêmico/imunologia , Linfócitos T Reguladores/imunologia , Células Th17/imunologia , Adulto , Animais , Células Cultivadas , Citocinas/imunologia , Feminino , Humanos , Interleucina-17/imunologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Membro 3 do Grupo F da Subfamília 1 de Receptores Nucleares/imunologia , FenótipoRESUMO
PURPOSE: We aimed to assess the relationship between electroencephalography (EEG) markers and seizure recurrence in cases with benign epilepsy with centrotemporal spikes (BECT) in a long-term follow-up study. METHODS: We analyzed the data of 52 children with BECT who were divided into 2 groups: the isolated group and recurrence group. The clinical profiles and initial/serial visual EEG recordings of both groups were evaluated. The entire follow-up period ranged from 12 to 65 months. RESULTS: None of the clinical characteristics differed between the 2 groups. Serial EEGs showed that the appearance of Rolandic spikes in the frontal region was more prevalent in the recurrence group. Moreover, a significant correlation was found between bilateral asynchronous discharges and seizure recurrence. However, on initial EEG of these patients, neither of the EEG features exhibited statistical significance. CONCLUSION: The presence of frontal focus and bilateral asynchrony appeared to be hallmarks of BECT patients with higher risk for seizure recurrence.
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Epilepsia Rolândica/fisiopatologia , Lobo Frontal/fisiopatologia , Convulsões/fisiopatologia , Criança , Pré-Escolar , Eletroencefalografia , Feminino , Humanos , Masculino , RecidivaRESUMO
In the present work, a simple solvothermal method is developed for the synthesis of hierarchical Co-based metal-organic framework (H-Co-MOF) microflowers. These microflowers are composed of nanosheets, consisting of small nanoflakes. Upon application as an electrode material in Li-ion batteries, H-Co-MOF shows ultrahigh specific capacity and long cycling performance. For instance, a remarkably superior capacity of 1345â mA h g-1 can be achieved after 100 cycles at a current density of 0.1â A g-1 . Even at 2â A g-1 , a large capacity of 828â mA h g-1 is maintained after 700 cycles. This excellent electrochemical performance might be ascribed to the intrinsic properties and unique hierarchical structure of the Co-based MOF.
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In this work, an Si/SiO2 -ordered-mesoporous carbon (Si/SiO2 -OMC) nanocomposite was initially fabricated through a magnesiothermic reduction strategy by using a two-dimensional bicontinuous mesochannel of SiO2 -OMC as a precursor, combined with an NaOH etching process, in which crystal Si/amorphous SiO2 nanoparticles were encapsulated into the OMC matrix. Not only can such unique porous crystal Si/amorphous SiO2 nanoparticles uniformly dispersed in the OMC matrix mitigate the volume change of active materials during the cycling process, but they can also improve electrical conductivity of Si/SiO2 and facilitate the Li+ /Na+ diffusion. When applied as an anode for lithium-ion batteries (LIBs), the Si/SiO2 -OMC composite displayed superior reversible capacity (958â mA h g-1 at 0.2â A g-1 after 100â cycles) and good cycling life (retaining a capacity of 459â mA h g-1 at 2â A g-1 after 1000â cycles). For sodium-ion batteries (SIBs), the composite maintained a high capacity of 423â mA h g-1 after 100â cycles at 0.05â A g-1 and an extremely stable reversible capacity of 190â mA h g-1 was retained even after 500â cycles at 1â A g-1 . This performance is one of the best long-term cycling properties of Si-based SIB anode materials. The Si/SiO2 -OMC composites exhibited great potential as an alternative material for both lithium- and sodium-ion battery anodes.
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BACKGROUND: Postoperative hypocalcemia caused by hypoparathyroidism is one of the most common morbidities of total thyroidectomy. The aim of this study was to analyze the kinetics and factors affecting PTH levels after total thyroidectomy and central neck dissection (CND). MATERIAL/METHODS: We performed a retrospective study in 438 consecutive patients who underwent total thyroidectomy between January 2007 and December 2010. No patient had a history of thyroid or neck surgery. PTH and calcium levels were recorded 1 day before the operation, during the first 5 days, and during follow-up (2 weeks and 2, 6, and 12 months). RESULTS: PTH levels declined to 41.90% of its initial value on the first day after the operation. After surgery, PTH was correlated positively with calcium and inversely with phosphate levels from postoperative day 1 to 14. Based on clinical observation, using a PTH threshold of <7 ng/L on postoperative day 1 was predictive of persistent hypoparathyroidism, with sensitivity and negative predictive value 100%, but poor specificity (70.19%). CND increased the risk of transient hypoparathyroidism compared with total thyroidectomy alone. Patients with thyroiditis had an increased risk of permanent hypoparathyroidism compared with those without thyroiditis. Iatrogenic removal of the parathyroid glands increased the risk of permanent hypoparathyroidism compared with those without iatrogenic parathyroidectomy. CONCLUSIONS: PTH declined on the first day after thyroidectomy. PTH levels <7 ng/L on the first day after surgery might be associated with persistent hypoparathyroidism. CND, thyroiditis, and iatrogenic parathyroidectomy increased the risk of hypoparathyroidism.
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Hipoparatireoidismo/sangue , Hipoparatireoidismo/etiologia , Hormônio Paratireóideo/sangue , Complicações Pós-Operatórias/sangue , Complicações Pós-Operatórias/etiologia , Tireoidectomia/efeitos adversos , Adulto , Cálcio/sangue , Feminino , Humanos , Hipocalcemia/sangue , Hipocalcemia/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Fatores de TempoRESUMO
INTRODUCTION: This study aims to assess the performance of the platelet count estimation using artificial intelligence technology on the MC-80 digital morphology analyzer. METHODS: Digital morphology analyzer uses two different computational principles for platelet count estimation: based on PLT/RBC ratio (PLT-M1) and estimate factor (PLT-M2). 977 samples with various platelet counts (low, median, and high) were collected. Out of these, 271 samples were immunoassayed using CD61 and CD41 antibodies. The platelet counts obtained from the hematology analyzer (PLT-I and PLT-O), digital morphology analyzer (PLT-M1 and PLT-M2), and flow cytometry (PLT-IRM) were compared. RESULTS: There was no significant deviation observed before and after verification for both PLT-M1 and PLT-M2 across the analysis range (average bias: -0.845/-0.682, 95% limit of agreement (LOA): -28.675-26.985/-29.420-28.056). When platelet alarms appeared, PLT-M1/PLT-M2 showed the strongest correlation with PLT-IRM than PLT-I with PLT-IRM (r: 0.9814/0.9796 > 0.9601). The correlation between PLT-M1/PLT-M2 and PLT-IRM was strong for samples with interference, such as large platelets or RBC fragments, but relatively weak in small RBCs. The deviation between PLT-M1 and PLT-M2 is related to the number of RBCs. Compared with PLT-I, PLT-M1/PLT-M2 showed higher accuracy for platelet transfusion decisions, especially for samples with low-value PLT. CONCLUSION: The novel platelet count estimation on the MC-80 digital morphology analyzer provides high accuracy, especially the reviewed result, which can effectively confirm suspicious platelet count.
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Objective: The objective of this study is to explore the utilization of next-generation sequencing (NGS) technology in evaluating the likelihood of identifying individuals with papillary thyroid microcarcinoma (PTMC ≤10 mm) who are at high or low risk. Design: NGS was used to analyze 393 formalin-fixed, paraffin-embedded tissues of PTC tumors, all of which were smaller than 15 mm. Results: The study found that bilateralism, multifocality, intrathyroidal spread, and extrathyroidal extension were present in 84 (21.4%), 153 (38.9%), 16 (4.1%), and 54 (13.7%) cases, respectively. Metastasis of cervical lymph nodes was identified in 226 (57.5%) cases and 96 (24.4%) cases with CLNM >5. Out of the total number of cases studied, 8 cases (2.3%) showed signs of tumor recurrence, all of which were localized and regional. Genetic alterations were detected in 342 cases (87.0%), with 336 cases revealing single mutations and 6 cases manifesting compound mutations. 332 cases (84.5%) had BRAFV600E mutation, 2 cases had KRASQ61K mutation, 2 cases had NRASQ61R mutation, 8 cases had RET/PTC1 rearrangement, 3 cases had RET/PTC3 rearrangement, and 1 case had TERT promoter mutation. Additionally, six individuals harbored concurrent mutations in two genes. These mutations were of various types and combinations: BRAFV600E and NRASQ61R (n = 2), BRAFV600E and RET/PTC3 (n = 2), BRAFV600E and RET/PTC1 (n = 1), and BRAFV600E and TERT promoter (n = 1). The subsequent analysis did not uncover a significant distinction in the incidence of gene mutation or fusion between the cN0 and cN1 patient cohorts. The presence of BRAFV600E mutation and CLNM incidence rates were found to be positively correlated with larger tumor size in PTMC. Our data showed that gene mutations did not appear to have much to do with high-risk papillary thyroid microcarcinoma (PTMC). However, when we looked at tumor size, we found that if the tumor was at least 5 millimeters in size, there was a higher chance of it being at high risk for PTM (P < 0.001, odds ratio (OR) = 2.55, 95% confidence interval (CI): 1.57-4.14). Identification of BRAFV600E mutation was not demonstrated to be significantly correlated with advanced clinicopathological characteristics, although it was strongly associated with a bigger tumor diameter (OR = 4.92, 95% CI: 2.40-10.07, P < 0.001). Conclusion: In clinical practice, BRAFV600E mutation does not consistently serve as an effective biomarker to distinguish high-risk PTMC or predict tumor progression. The size of the tumor has a significant correlation with its aggressive characteristics. PTMC with a diameter of ≤5 mm should be distinguished and targeted as a unique subset for specialized treatment.
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Background/Objective: Reticulocyte hemoglobin content (MCHr) was recognized as a rapid and reliable marker for investigating iron deficiency (ID). We hypothesized that MCHr was associated with the risk of iron deficiency anemia in adults. Methods: This is a dual-center case-control study. A total of 806 patients and healthy individuals were recruited from Ruijin Hospital and Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine between January 2021 and December 2021. The participants were categorized into iron deficiency anemia (IDA) group (n = 302), non-IDA group (n = 366), and healthy control group (n = 138). According to the MCHr level, the participants were divided into two groups, i.e. normal MCHr (≥25 pg) and decreased MCHr (<25 pg) group. Multivariate logistic regression analysis and adjusted subgroup analysis were conducted to estimate the relative risk between MCHr and IDA, with confounding factors including age, sex, hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), Hematocrit (HCT), serum iron (Fe), ferritin (Ferrit), and total iron binding capacity (TIBC). Results: Compared with the non-IDA, the MCHr level with IDA decreased significantly. ROC curve analysis showed that MCHr had the largest area under the AUC curve. After comprehensive adjustment for confounding factors, individuals with normal level of MCHr exhibited a decreased risk of IDA (OR = 0.68 [0.60, 0.77], P < 0.01), while the risk of IDA was up to 5 times higher for those with decreased MCHr. Conclusion: Our findings supported the hypothesis that MCHr was associated with the risk of IDA in adults and could serve as an indicator of IDA severity. MCHr holds clinical value as an auxiliary diagnostic indicator, providing valuable insights into whether invasive examinations are warranted in the assessment of IDA.
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OBJECTIVE: To analyze the clinical phenotype and genetic characteristics of a female proband carrying a novel mutation in the DMD gene with non-random X-chromosome inactivation in a large pedigree with pseudohypertrophic muscular dystrophy. METHODS: Clinical information of the female proband, her monozygotic twin sister, and other family members were collected. Potential pathogenic variants were detected with Multiplex Ligation-dependent Probe Amplification (MLPA) and whole-exome sequencing (WES). Methylation-sensitive restriction enzyme (HhaI) was employed for X-chromosome inactivation analysis. RESULTS: The proband was a female over 5 years old, displayed clinical manifestations such as elevated creatine kinase (CK) levels and mild calf muscle hypertrophy. Her monozygotic twin sister exhibited normal CK levels and motor ability. Her uncle and cousin had a history of DMD. WES revealed that the proband carried a novel variant in the DMD (OMIM: 300,377) gene: NM_004006.3: c.3051_3053dup; NP_003997.2: p.Tyr1018*. In this pedigree, five out of six female members were carriers of this variant, while the cousin and uncle were hemizygous for this variant. X-chromosome inactivation analysis suggested non-random inactivation in the proband. CONCLUSION: The c.3051_3053dup (p.Tyr1018*) variant in the DMD gene is considered to be the pathogenic variant significantly associated with the clinical phenotype of the proband, her cousin, and her uncle within this family. Integrating genetic testing with clinical phenotype assessment can be a valuable tool for physicians in the diagnosis of progressive muscular dystrophies, such as Becker muscular dystrophy (BMD) and Duchenne muscular dystrophy (DMD).
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Distrofia Muscular de Duchenne , Humanos , Feminino , Pré-Escolar , Distrofia Muscular de Duchenne/genética , Testes Genéticos , Fenótipo , Mutação , CromossomosRESUMO
BACKGROUND: This study investigated the performance of the MC-100i, a pre-commercial digital morphology analyzer utilizing a convolutional neural network algorithm, in a multicentric setting involving up to 11 tertiary hospitals in China. METHODS: Blood smears were analyzed by MC-100i, verified by morphologists, and manually differentiated. The classification performance on WBCs and RBCs was evaluated by comparing the classification results using different methods. The PLT and PLT clump counting performance was also assessed. The total assay time including hands-on time was evaluated. RESULTS: The agreements between pre- and post-classification were high for normal WBCs (κ > 0.96) and lower for overall abnormal WBCs (κ = 0.90). The post-classification results correlated well with manual differentials for both normal and abnormal WBCs (r > 0.93), except for basophils (r = 0.8480) and atypical lymphocytes (r = 0.8211). The clinical sensitivity and specificity of each RBC abnormality after verification were above 90 % using microscopy reviews as the reference. The PLTs counted by the MC-100i before and after verification correlated well with those measured by the PLT-O mode (r = 0.98). Moreover, PLT clumps were successfully classified by the analyzer in EDTA-dependent pseudothrombocytopenia blood samples. CONCLUSIONS: The MC-100i is an accurate and reliable digital cell morphology analyzer, offering another intelligent option for hematology laboratories.
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Hematologia , Leucócitos , Humanos , Centros de Atenção Terciária , Eritrócitos , China , Reprodutibilidade dos TestesRESUMO
Mono-ADP-ribosyltransferase 2 (ART2) is found in mouse T cells and has mediated NAD-induced cell death (NICD) alongside the P2X7 pathway. We determined whether ART2 was expressed in mouse brain astrocytes and the possible function of the NAD-ART2-P2X7 pathway in astrocytes. Our results demonstrate that ART2 existed both in cultured mouse astrocytes and mouse brain slices. Exposure of astrocytes to the ART2 substrate, NAD, induced calcium elevation, which was blocked by ART2 and P2X7 inhibitors. ATP and NAD had an additive effect on calcium elevation. NICD in low-calcium conditions was blocked by ART2 and P2X7 inhibitors. The harmful effect of ATP on astrocytes was inhibited by P2X7 and ART2 inhibitors, meaning that endogenous NAD release may occur. Both NICD function and oxygen-glucose deprivation injury in mouse brain slices were also involved in the ART2-P2X7 pathway. Collectively, to our knowledge, our study provides the first evidence that ART2 exists in mouse brain astrocytes and NAD induces calcium elevation and astrocyte death by an ART2 and P2X7-mediated mechanism. The results suggest a novel approach for manipulating astrocyte death.
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ADP Ribose Transferases/metabolismo , Astrócitos/citologia , Astrócitos/metabolismo , Sinalização do Cálcio/efeitos dos fármacos , Cálcio/metabolismo , NAD/farmacologia , Receptores Purinérgicos P2X7/metabolismo , ADP Ribose Transferases/genética , Trifosfato de Adenosina/farmacologia , Animais , Astrócitos/efeitos dos fármacos , Encéfalo/citologia , Encéfalo/efeitos dos fármacos , Encéfalo/metabolismo , Morte Celular/efeitos dos fármacos , Células Cultivadas , Regulação da Expressão Gênica/efeitos dos fármacos , Masculino , CamundongosRESUMO
The aim of the present study was to evaluate the association between coexisting lymphocytic thyroiditis (LT) and the clinicopathological features of papillary thyroid carcinoma (PTC). The records of 458 patients with PTC who underwent a total thyroidectomy and lymph node dissection in Sir Run Run Shaw Hospital (Hangzhou, China) were analyzed. In accordance with the histopathology of thyroid parenchyma, the cases were divided into three groups, including Hashimoto's thyroiditis (HT), non-Hashimoto's type LT (NHLT) and no LT. Based on the histopathology, data on age, sex, maximum diameter of tumor, multifocality, extrathyroidal extension, metastatic lymph node size, extranodal extension and tumor grades in the different groups were analyzed and compared. The prevalence of coexisting LT was 29.0% (133/458), of which 7.6% (35/458) was HT and 21.4% (98/458) was NHLT. PTC concomitant with LT was significantly associated with female patients (95.5 vs. 70.2%; P<0.001), a lower rate of extrathyroidal extension and/or capsular invasion (25.6 vs. 39.7%; P=0.004), central lymph node metastasis (CLNM) ratio (10.71 vs. 17.37; P=0.014), higher number of dissected central lymph nodes (16.83 vs. 11.7; P<0.001), larger metastatic lymph nodes (0.66 vs. 0.46 cm; P<0.001), higher occurrence of multifocality (61.7 vs. 50.5%; P=0.029) and earlier pT stage (57.9 vs. 38.8%; P<0.001), regardless of the combined or separate consideration of HT and NHLT. Besides, LT was associated with multifocality [odds ratio (OR), 1.578; 95% confidence interval (CI), 1.046-2.382; P=0.030]. Furthermore, in patients with PTC, CLNM had a significant association with the male sex (OR, 2.000; 95% CI, 1.216-3.288; P=0.006), an age of <45 years (OR, 0.592; 95% CI, 0.398-0.879; P=0.009) and a tumor size of >1 cm (OR, 3.913; 95% CI, 2.431-5.734; P<0.001). In conclusion, patients with PTC and LT showed a greater female preponderance, multifocality, a lower extrathyroidal extension and a lower CLNM ratio. LT was associated with an increased risk of multifocality in PTC.
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Objective: When active surveillance (AS) is developed in the patients with low-risk papillary thyroid microcarcinoma (PTMC), a medical center needs to ensure the delayed operation that is caused by PTMC clinical progression to have the same prognosis as that of immediate operation. The objective of this study was to investigate the efficacy of delayed surgery by simulating clinical progression (tumor size enlargement and appearance of lymph node metastasis) of PTMCs with AS in a single medical center. Methods: We retrospectively analyzed the response to therapy in 317 papillary thyroid carcinoma patients treated with total thyroidectomy and post-operative radioactive iodine ablation. They were classified into three groups according to tumor size (group A ≤0.5 cm; group B >0.5 cm and ≤1 cm; group C >1 cm and ≤1.5 cm) or two groups according to the presence (cN1) or absence (cN0) of the clinical lymph node (LN) metastasis. Groups C and cN1 were regarded as simulated clinical progression of observational PTMC and the operation for them was assumed to be "delayed surgery". However, Groups A, B and cN0 were regarded as no clinical progression and the operation for them was considered as immediate surgery. Results: There were no significantly differences in excellent response to therapy and recurrence-free survival not only among the group A, B and C, but also between the group cN0 and cN1. In other words, these insignificant differences were found between immediate and simulated "delayed" surgeries. Conclusion: For the PTMC patients suitable for AS, the oncological outcomes were also excellent even if surgery was delayed until after the presence of clinical progression, according to our clinical simulation. Furthermore, we consider that it was feasible for medical centers to assess the ability to implement AS for PTMC patients by retrospectively analyzing their own previous clinical data using the described simulation.
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Green hydrogen produced via electrochemical water splitting is a suitable candidate to replace emission-intensive fuels. However, the successful widespread adoption of green hydrogen is contingent on the development of low-cost, earth-abundant catalysts. Herein, machine learning models built on experimental data were used to optimize the precursor ratios of hydroxide-based electrocatalysts, with the objective of improving the product's electrocatalytic performance for overall water splitting. The Neural Network-based models were found to be the most effective in predicting and minimizing the overpotentials of the catalysts, reaching a minimum in two iterations. The relatively mild reaction conditions of the synthesis procedure, coupled with its scalability demonstrated herein, renders the optimized catalyst relevant for industrial implementation in the future. The optimized catalyst, characterized to be a molybdate-intercalated CoFe LDH, demonstrated overpotentials of 266 and 272 mV at 10 mA cm-2 for oxygen and hydrogen evolution reactions respectively in alkaline electrolyte, alongside unwavering stability for overall water splitting over 50 h. Overall, our results reflect the efficacy and advantages of machine learning strategies to alleviate the time and labour-intensive nature of experimental optimizations, which can greatly accelerate electrocatalysts research.
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OBJECTIVE: To evaluate the performance of new optical platelet measurement channel on the BC-6800 Plus automated blood cell analyzer. METHODS: The basic PLT count performance of the BC-6800 Plus was evaluated according to the requirements of the Clinical Laboratory and Standards Institute (CLSI) Document H26-A2. In addition, low-PLT-value specimens, red blood cell debris specimens, small red blood cell specimens, and giant PLT specimens were detected with the blood cell analyzer and a flow cytometer. Whole-blood specimens in ethylenediaminetetraacetic acid (EDTA) or sodium citrate anticoagulant tubes from 20 patients with EDTA-dependent PLT aggregation were determined in CDR mode of the analyzer. RESULTS: Blank counting and the carryover contamination rate of PLTs using the BC-6800 Plus both met the technical requirements. For abnormal PLT specimens, PLT-O 8× and PLT-I both exhibited high comparability with flow cytometry. The comparability of PLT-O 8× with flow cytometry was better than that of PLT-I. In EDTA-anticoagulated blood specimens from 20 patients with EDTA-dependent PLT aggregation, the results of PLT-O were significantly higher than those for PLT-I using samples from the same tubes (P < .001). However, the PLT counts were similar between these two methods for sodium citrate-anticoagulated blood specimens (P = .263). CONCLUSION: The performance of PLT-O 8× in the BC-6800 Plus met the technical requirements. PLT-O 8× exhibited better reproducibility than did PLT-I for low-PLT-value samples. Reexamination of abnormal PLT specimens using PLT-O 8× yielded more accurate results. PLT-O performed significantly better than PLT-I in the detection of EDTA-dependent PLT-aggregation specimens.